Top Dawg Registration



$60 for early register (January 1 – March 31)
$70 for late registration (April 1 – April 30)
Free for Top Pup competitor
Deadline: April 30, 2019

#1 – Submit the complete registration form below
#2 – Make a payment for registration
Please make sure you do both, your registration is not completed until you do both #1 AND #2

Competitor: FreediverScuba Diver

Division: Top DawgTop Pup (16 years of age and younger)

First Name:

Last Name:

Email:

Address:

City:

State:

Zip:

Phone:

Emergency Contact Name:

Emergency Contact Relation:

Emergency Phone:

Best way to contact you: PhoneEmailText

Email Subcription:YesNo

(Top Pup Only) Age:

Payment:
CashPersonal CheckPaypal (plus $2.50 processing fee)$70 Top DawgTop Pup - FREE

Flexfit hat size:
S/MM/L